Acquired Immunodeficiency Syndrome: Chen D

Chen D, Lalwani AK, House JW, Choo D. · Department of Otolaryngology Head and Neck Surgery, University of California San Francisco, 94143-0342, USA. · Am J Otol. · Pubmed #10503576 No free full text.

Abstract: OBJECTIVE: This study aimed to analyze the clinical presentation, diagnosis, management, and results of treatment in a series of three patients with acquired immunodeficiency syndrome (AIDS) in whom Aspergillus mastoiditis developed. This study also aimed to compare these aspects of Aspergillus mastoiditis in patients with AIDS with three additional cases present in the current literature. A classification system for fungal infections of the ear and temporal bone is proposed. STUDY DESIGN: The study design was a retrospective case review. SETTING: The study was conducted at multiple tertiary referral centers. PATIENTS: Three individuals with diagnosed AIDS and mastoiditis resulting from culture-proven Aspergillus were studied. INTERVENTION: Patients were treated with both medical and surgical methods including local and systemic antimicrobial/antifungal agents and mastoidectomy. MAIN OUTCOME MEASURES: These measures included return of facial nerve function, control/resolution of disease, and survival. RESULTS: All three patients in this series initially presented with otalgia and otorrhea and intact facial nerve function. Facial nerve paresis developed in all patients between 5 and 12 weeks after initial symptoms. Paresis uniformly improved or resolved after mastoidectomy. Two patients treated with systemic antifungal therapy and prompt surgical debridement after development of facial palsy had full resolution of infection. One patient had full recovery of facial paresis and the other had partial recovery. The third patient was lost to follow-up after initial treatment with antimicrobials and surgery and died 3 months later without a clear etiology. CONCLUSIONS: Aspergillus mastoiditis is an unusual infection in patients with AIDS. Because of its rarity, fungal mastoiditis in immunocompromised individuals can result in a significant delay in diagnosis and treatment. The decision between conservative antimicrobial therapy and aggressive surgical treatment also can present a therapeutic challenge in the management of these life-threatening infections, especially in patients with existing immunodeficiency and illness. Early surgical debridement followed by antimicrobial therapy may be life preserving in this patient population.

Pang H, Chen D, Cui QC, Dou QP. · The Prevention Program, Barbara Ann Karmanos Cancer Institute, and Department of Pathology, School of Medicine, Wayne State University, Detroit, MI 48201, USA. · Int J Mol Med. · Pubmed #17390087 No free full text.

Abstract: Diethyldithiocarbamate (DDTC) is a member of the dithiocarbamate family and a potent copper-chelating agent. DDTC was used in a clinical trial for patients with HIV-1 infection and showed a significant delay in progression to AIDS. In this study, we investigated the effects of DDTC-copper complex in human prostate and breast cancer cells. We found that DDTC was capable of binding copper and forming a new complex that potently inhibited the proteasomal chemotrypsin-like activity, decreased expression of androgen receptor (AR), estrogen receptor (ER) alpha and ERbeta proteins, and induced apoptosis in both prostate and breast cancer cells. Our data support the concept of using accumulated copper in cancer cells and tissues as a novel target for chemotherapy. This study provides a mechanistic interpretation for utilization of copper chelators in cancer treatment.

Huang Y, Chen D, Jin B, Ge Y, Wan C, Zhu Z, Zhu G, Hong P. · Laboratory of Reproduction & Genetics, Nanjing General Hospital of Nanjing Command, PLA, Nanjing, Jiangsu 210002, China. · Zhonghua Nan Ke Xue. · Pubmed #15638015 No free full text.

Abstract: OBJECTIVE: To understand the knowledge, attitude, behavior and perception (KABP) related to STD/AIDS among the high-risk population and to explore effective methods for health education and behavioral intervention. METHODS: Seven hundred and twenty of the reeducated in a reeducation center were surveyed using questionnaires, which were collected and analyzed. RESULTS: The knowledge of the subjects about STD/AIDS was insufficient. When they had sex with their clients, the preventive measures against STD/AIDS were incorrect and the proportion of condom use was small. And when infected with STD/AIDS, they turned to private clinics for nonstandard treatment. CONCLUSION: The knowledge of save sex and the preventive measures against STD/AIDS need to be improved, and correct guidance is imperative as to the seeking of standard medical help among the high-risk population. The key to sexual health education was to establish a corresponding social supporting system.

Chien PC, Chen D, Chen PD, Tuen M, Cohen S, Migueles SA, Connors M, Rosenberg E, Malhotra U, Gonzalez C, Hioe CE. · Department of Pathology, New York University School of Medicine, and Veterans Affairs New York Harbor Healthcare System, New York, New York 10010, USA. · J Infect Dis. · Pubmed #14976603 No free full text.

Abstract: BACKGROUND: Antibodies to the CD4-binding domain (CD4bd) of human immunodeficiency virus type 1 (HIV-1) glycoprotein 120 (gp120) inhibit gp120 antigen presentation to CD4 T cells. These findings imply that the presence of anti-CD4bd antibodies might contribute to the dearth of envelope-specific T helper responses observed in most HIV-1-positive patients. In the absence of these antibodies, however, anti-envelope T helper responses might be maintained. METHODS: We used ELISA to evaluate the levels of anti-CD4bd antibodies in rare HIV-1-positive patients who exhibit envelope-specific lymphoproliferation. Subsequently, we examined the contribution of anti-CD4bd antibodies to disease progression by comparing anti-CD4bd antibody levels in 3 cohorts of HIV-1-positive patients with distinct rates of disease progression. RESULTS: Although most HIV-1-positive individuals produce anti-CD4bd antibodies, 77% of patients with envelope-specific lymphoproliferation have undetectable anti-CD4bd antibody levels. Moreover, comparison of the 3 HIV-1-positive cohorts revealed that individuals with long-term nonprogression have significantly lower anti-CD4bd antibody titers than do those with rapid or slow progression. Unlike immunoglobulin G (IgG) from rapid progressors, IgG from nonprogressors had no suppressive effects on glycoprotein (gp) 120-specific T cell proliferation. CONCLUSIONS: Low anti-CD4bd antibody levels are associated with the absence of disease progression. A number of HIV-1-positive individuals without these antibodies also appear to sustain gp120-specific T helper responses needed to help control the infection.